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Thoracic aortic pulsatility decreases during hypovolemic shock: implications for stent-graft sizing
Frederik H W Jonker1, Jasper W van Keulen, Felix J V Schlosser
1Section of Vascular Surgery, Maasstad Hospital, Rotterdam, The Netherlands.
Summary
Hypovolemic shock significantly reduces thoracic aortic pulsatility and diameter in pigs. This finding suggests that detailed imaging may be unnecessary for certain hypovolemic patients undergoing aortic repair.
Area of Science:
- Cardiovascular Physiology
- Surgical Research
Background:
- Hypovolemic shock presents a critical challenge in managing acute aortic diseases.
- Understanding hemodynamic changes in the thoracic aorta is crucial for effective treatment.
Purpose of the Study:
- To quantify changes in thoracic aortic pulsatility during experimentally induced hypovolemic shock.
- To assess the impact of reduced blood volume on aortic dimensions and pulsatility in a porcine model.
Main Methods:
- Seven Yorkshire pigs underwent gradual blood volume reduction to 40% of normal.
- Intravascular ultrasound was employed to measure aortic pulsatility and diameter at the ascending and descending thoracic aorta.
Main Results:
- Aortic pulsatility significantly decreased in both the ascending (15.9% to 6.2%) and descending (8.7% to 5.6%) thoracic aorta during hypovolemia (p < 0.05).
- The maximum aortic diameter in systole was also significantly reduced at both levels.
- The most pronounced reduction in pulsatility was observed in the ascending aorta.
Conclusions:
- Hypovolemic shock leads to significant reductions in thoracic aortic diameter and pulsatility.
- Minimal aortic pulsatility in hypovolemic states may simplify imaging requirements for endovascular aortic repair.
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